Air Nurses Take Job In Stride

February 27, 1986|By Shari Roan, Health Writer

Nancy Thull and Shirley Passaro have learned to expect phone calls in the middle of the night. The nurses know a call will mean they must be at Fort Lauderdale-Hollywood International Airport within the hour to help load an airplane with equipment and supplies. They won`t know how long the trip will take or how critical the patient will be when they arrive. But those unknown factors are what make their jobs as air ambulance nurses so challenging.

``You may have a burn patient Monday night, a trauma victim Tuesday night and a 1 1/2-pound baby Wednesday night. You have to be very flexible,`` says Thull, 26, the chief flight nurse for Air Ambulance Associates.

``Every trip is so different, especially in the Caribbean and South America,`` says Passaro, 37, a full-time nurse at Air Ambulance Associates.

Passaro recalls a harrowing 17-hour flight from Rome to Miami transporting a burn patient. The patient survived the trip but later died.

``There are things you wouldn`t see in the United States,`` says Passaro, who, with Thull, co-teaches a course on aviation medicine at Broward Community College. ``You can`t get a lab report or you can`t get an X-ray. It`s a challenge.``

And you never know what`s going to happen, says Thull.

Thull says her most memorable experience happened two years ago while transporting a Stuart woman who was in premature labor to Tampa. When the helicopter was near the edge of Lake Okeechobee, the woman delivered a tiny 1.4-ounce child still in the fetal sac.

The pilot brought the helicopter down in a farmer`s field and the medical team quickly threw open the doors and began emergency measures to save the child. While the medical team hovered over the infant, the pilot held the mother`s hand and a farmer and several cows gathered around the helicopter to watch. After stabilizing the child, the helicopter went on to Tampa. The child lived. Her parents sometimes bring her by the Air Ambulance offices to visit.

On another occasion, Thull flew in an Air Ambulance Learjet, one of five emergency medical aircraft owned by the company, to Iquitos, Peru, in the Amazon to transport an American Exxon executive who had had a heart attack. When the Air Ambulance team arrived, there was no ground ambulance to transport the man to the airport or oxygen tank. Thull cared for the man in an open jeep during a ride through the jungle.

``You learn to expect the worst,`` says Thull, with a shrug.

But despite the surprises, a lot of planning goes into every flight, says Walter Muharsky, general manager of Air Ambulance Associates.

When a call comes for an air ambulance, a medical director quickly assesses the situation, chooses the appropriate aircraft for the job and calls in a flight crew. At Air Ambulance Associates, there are medical personnel on call at all times, including 19 nurses, 27 doctors, five respiratory therapists and three profussionists. A heart patient who requires an intra-aorta balloon pump, for example, may need a doctor, two nurses, a respiratory therapist and a profussionist (a technician skilled in using the pump) on board. Other times, only a nurse is needed to transport a patient.

The team is not just involved in the flight, says Muharsky, but cares for the patient from the moment the team enters the hospital, throughout the flight and until the patient is stable at the receiving hospital.

Once aboard the aircraft, medicine takes on a whole different approach, says Thull.

``This is a new field of medicine,`` says Thull. ``There are a lot of differences in treating people in the air.``

The medical team must worry about the cabin pressure and temperature of the aircraft. Intravenous lines don`t drip properly at high altitudes and require a pump to work. The medical team must also deal with a strange environment. The helicopter interior, for example, tends to give off a rosy light that can lead a nurse or doctor to think a newborn is a good color when the baby may not be. The team must also contend with the noise of the aircraft, which can muffle sounds that signal something is wrong. And many special precautions must be taken for the flight. For example, the medical team must remember to strap a baby in the incubator. Just a little turbulence could throw a 2-pound baby against the roof of the incubator.